- The Detroit Center for Research on Oral Health Disparities aims to promote oral health and reduce disparities within the community of low-income African American children (0-5 years) and their main caregivers (14 + years) living in the City of Detroit. The driving theme of the center's research program is to identify determinants and design interventions to answer the following question: why do some low-income African American children and their main caregivers have better oral health than others who live in the same community? The proposed center will focus on studying intra-group disparities in oral health. The community based partners, the City of Detroit Department of Health (DDH) and the Voices of Detroit Initiative (VODI) have strongly supported this theme. The Center will include 3 support cores, 5 research core projects and 1 pilot study. The Center's Methodology Core will select a multistage random sample of African American families living in the poorest 39 Census Tracts in the City of Detroit. A total of 1,529 families will be sampled and interviewed in their homes. It is estimated that 994 families will be examined at community centers in year 2 (2002) funding. Based on extensive data collected by the investigative team (R01 MH58299) in Detroit, the investigators predict that 760 families will be retained by the third examination phase in year 6 (2006). The research teams will investigate the social characteristics of parents, families, and neighborhoods, that are associated with disparities in oral health (dental caries and periodontal diseases) of children and their caregivers; lead levels in saliva of children and saliva and blood (finger prick) of the main caregivers; dietary intake; and genetic, behavioral, social and bacteriologic risk factors of periodontal disease in adults. Using information from 3 core research projects, the investigators propose to develop a tailored multi-media educational intervention (Project #3), based on the transtheoretical model of behavioral change, which will be administered using a randomized controlled design in year 4 of funding, just prior to the second examination phase. Additionally, the center will evaluate the impact on access to dental care of the state-funded experiment on utilization where Medicaid children are managed like privately insured patients (Project #4). The center will support health professionals from the DDH and VODI and the University of Detroit Mercy to receive research training. Doctoral students in three programs targeting minorities in the Schools of Public health and Social Work will be offered stipends to conduct research on health disparities. All families will have access to dental care in a DDH dental clinic (funded by DDH, HRSA, Delta Dental of Michigan and VODI).